It took until late 2010 for the College of Dental Surgeons to end the practice of a B.C. dentist who has been the target of dozens of complaints and lawsuits from patients since the mid-1980s.

Dr. Derek Duvall was able to continue practising on and off for more than two decades by changing provinces twice, moving cities frequently and initiating legal action against the B.C. college when it tried to impose restrictions on his professional activities. One of those restrictions was an agreement requiring Duvall to see a psychiatrist and obtain medications regularly to treat a mental illness, which is now at the centre of a discrimination complaint Duvall filed against the college at the B.C. Human Rights Tribunal.

Most recently, Duvall was cited for 33 instances of incompetent practice and professional misconduct that occurred during 2006, 2007 and 2009, including removing four permanent teeth from a patient without informed consent, permanently cementing a damaged bridge to a patient’s mouth and botching numerous procedures such as root canals and crown placements, according to the college’s disciplinary panel.

Duvall has practised in many B.C. communities since he registered with the college in 1973, including Comox/Courtenay, White Rock, Kamloops, Gibsons, Vernon, Kelowna, Clearbrook, Fort St. John, Chetwynd and Delta, said college spokeswoman Anita Wilks.

The complaints against Duvall date back to June 1984, when Comox Valley resident John Evaniuk wrote to the college to complain about root canals and fillings performed by Duvall the previous year. Afterward, Evaniuk experienced symptoms including chronic pain and numbness, according to a 1991 letter to then-health minister John Jansen from Evaniuk’s MLA, Stan Hagen, cited in the legislative Hansard.

A College of Dental Surgeons review committee recommended in 1985 that Duvall both reimburse Evaniuk for the work that was done and pay for the corrective work required to fix it, estimated at $10,000, but the college was powerless to enforce that recommendation and Duvall did not honour it, Hagen’s letter said.

“My own concern, beyond the college’s inability to enforce its own recommendations, is that this dentist is still licensed to practice in British Columbia,” Hagen wrote in 1991. “Mr. Evaniuk is not the only individual to raise concerns pertaining to this practitioner. My office is aware of at least three other people who have alleged similar problems and have accordingly passed their concerns on to the college.”

Duvall was in good standing with the college until 1989, when a review committee set out a number of concerns regarding Duvall’s treatment of about a dozen patients and recommended an inquiry, Wilks said in a statement, but the inquiry never took place. Duvall allowed his registration to lapse in March 1991, Wilks said, and later registered with the Alberta Dental Association.

“Our suspicion is that we lost jurisdiction once he was no longer registered in B.C.,” Wilks said, adding that the college has no record of any complaints against Duvall between 1989 and 2007.

Duvall practised in Peace River, Alta. in the mid-1990s, but closed that practice in 1998. A discipline hearing related to an investigation of complaints against Duvall was scheduled in Alberta for later that year, but that, too, never took place.

“The Alberta Dental Association indicated that a hearing into Duvall’s practice had been adjourned generally for medical reasons and Dr. Duvall had taken a voluntary leave of indefinite duration until he could provide evidence that he is fit and competent to engage in the practice of dentistry and that he has met all the statutory requirements,” Wilks said.

Duvall applied to return to practice in B.C. in 2002 and the college allowed him to do so the following year, but required him to sign an agreement to disclose any changes in his medical status to the college, obtain his medications regularly and cease practising dentistry if he was no longer being treated by a certain psychiatrist.

The college does not name the medical condition, but B.C. Human Rights Tribunal documents state Duvall was diagnosed with bipolar disorder in 1984 and started regular treatment with a psychiatrist in 1995. In 2003, when Duvall was seeking to resume practice in B.C., that psychiatrist informed the college that Duvall “no longer has any mental illness of sufficient degree to prevent his successfully practicing dentistry,” according to human rights tribunal documents.

The psychiatrist and Duvall’s family doctor were also required to report directly to the college on changes to Duvall’s medical condition under the terms of the agreement, which “attempted to strike a balance that would protect the public while taking into account Dr. Duvall’s condition and providing him with an opportunity to earn a livelihood,” according to a statement on the college’s website.

In the human rights complaint, filed in 2010, Duvall accuses the college of discriminating against him by imposing conditions on his registration that interfere with his ability to practise because it mistakenly believes him to suffer from bipolar disorder, and ignoring medical evidence that he does not suffer from that, or any other disorder. The tribunal has dismissed parts of Duvall’s complaint as untimely, but has yet to issue a final decision in the case.

The college began receiving complaints about Duvall again in 2007 and started an investigation soon after, Wilks said.

In March 2010 the college denied Duvall’s renewal application because of a concern that he had breached the terms of the agreement, but Duvall initiated a lawsuit to compel the college to allow him to register.

“Given the information the college had at the time, he was entitled to have his registration renewed,” Wilks said.

Duvall is now the target of a lawsuit from Delta resident Jesse MacGregor over dental work Duvall allegedly performed between May and October, 2010. MacGregor alleges in the lawsuit that Duvall’s treatments began to fail soon after, left him in pain and required extensive reparations at significant cost. None of the allegations have been proven in court.

At the end of 2010 the college required Duvall to cease practice for breaching his agreement and he has not practised since, Wilks said.

The college’s disciplinary panel is considering what Duvall’s penalty should be for the 33 instances of incompetent practice and professional misconduct it identified earlier this year. The college has asked that Duvall be removed from the register and not be allowed to reapply until he has completed a dental program at a recognized institution and written the board exams, Wilks said. The college has also asked that Duvall pay $95,000 in costs.

“Cancellation from the register is the most serious penalty the college can impose and is the dentist equivalent of a disbarment,” Wilks said.

The law firm representing Duvall in the college’s disciplinary investigation did not respond to a request for comment.

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B.C. dentist practised despite dozens of complaints spanning more than two decades

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